Evaluation of an Amino Acid-Based Formula in Infants Not Responding to Extensively Hydrolyzed Protein Formula

Overview

Journal J Pediatr Gastroenterol Nutr

Publisher Wiley

Date 2016 Aug 16

PMID 27526059

Citations 6

Authors

Jon Vanderhoof

Nancy Moore

Delphine de Boissieu

Affiliations

Soon will be listed here.

Abstract

Nearly 2% to 3% of infants and children younger than 3 years have confirmed cow's milk protein allergy with multiple clinical presentations including atopic dermatitis (AD), diarrhea, and vomiting/spitting up. Although most infants with cow's milk protein allergy experience clinical improvement with the use of an extensively hydrolyzed (EH) formula, highly sensitive infants may require an amino acid-based formula. In this observational, prospective study, 30 infants (1-12 months of age) with a history of weight loss and persistent allergic manifestations while on an EH formula were provided an amino acid-based formula for 12 weeks. Mean weight gain (z score change) improved +0.43 ± 0.28 (mean ± standard deviation) after the 12-week feeding period. Improvement was observed for many allergic symptoms including significant decreases in AD severity (P = 0.02). These results indicate the new amino acid-based infant formula supported healthy weight gain and improvement in allergic manifestations in infants not responding to EH formulas.

Citing Articles

The use of amino acid formulas in pediatric patients with allergy to cow's milk proteins: Recommendations from a group of experts.

Ribes-Koninckx C, Amil-Dias J, Espin B, Molina M, Segarra O, Diaz-Martin J Front Pediatr. 2023; 11:1110380.

PMID: 37033186 PMC: 10073469. DOI: 10.3389/fped.2023.1110380.

Can fecal calprotectin levels be used to monitor infant milk protein allergies?.

Qiu L, Wang J, Ren F, Shen L, Li F Allergy Asthma Clin Immunol. 2021; 17(1):132.

PMID: 34903286 PMC: 8670270. DOI: 10.1186/s13223-021-00636-0.

Consensus statement on the epidemiology, diagnosis, prevention, and management of cow's milk protein allergy in the Middle East: a modified Delphi-based study.

El-Hodhod M, El-Shabrawi M, AlBadi A, Hussein A, Almehaidib A, Nasrallah B World J Pediatr. 2021; 17(6):576-589.

PMID: 34817828 PMC: 8639571. DOI: 10.1007/s12519-021-00476-3.

A free amino acid-based diet partially prevents symptoms of cow's milk allergy in mice after oral sensitization with whey.

van Sadelhoff J, Hogenkamp A, Wiertsema S, Harthoorn L, Loonstra R, Hartog A Immun Inflamm Dis. 2020; 8(1):93-105.

PMID: 32031763 PMC: 7016843. DOI: 10.1002/iid3.288.

Hypoallergenicity of a thickened hydrolyzed formula in children with cow's milk allergy.

Rossetti D, Cucchiara S, Morace A, Leter B, Oliva S World J Clin Cases. 2019; 7(16):2256-2268.

PMID: 31531320 PMC: 6718785. DOI: 10.12998/wjcc.v7.i16.2256.

References

Dupont C, Chouraqui J, De Boissieu D, Bocquet A, Bresson J, Briend A . Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. Br J Nutr. 2011; 107(3):325-38. DOI: 10.1017/S0007114511004831. View

Hoffman K, Sampson H . Serum specific-IgE antibodies to peptides detected in a casein hydrolysate formula. Pediatr Allergy Immunol. 1998; 8(4):185-9. DOI: 10.1111/j.1399-3038.1997.tb00158.x. View

Sicherer S, Noone S, Koerner C, Christie L, Burks A, Sampson H . Hypoallergenicity and efficacy of an amino acid-based formula in children with cow's milk and multiple food hypersensitivities. J Pediatr. 2001; 138(5):688-93. DOI: 10.1067/mpd.2001.113007. View

Host A, Halken S . Cow's milk allergy: where have we come from and where are we going?. Endocr Metab Immune Disord Drug Targets. 2014; 14(1):2-8. DOI: 10.2174/1871530314666140121142900. View

Niggemann B, Binder C, Dupont C, Hadji S, Arvola T, Isolauri E . Prospective, controlled, multi-center study on the effect of an amino-acid-based formula in infants with cow's milk allergy/intolerance and atopic dermatitis. Pediatr Allergy Immunol. 2001; 12(2):78-82. DOI: 10.1034/j.1399-3038.2001.012002078.x. View

de Boissieu D, Dupont C . Allergy to extensively hydrolyzed cow's milk proteins in infants: safety and duration of amino acid-based formula. J Pediatr. 2002; 141(2):271-3. DOI: 10.1067/mpd.2002.126299. View

Isolauri E, Sutas Y, Makinen-Kiljunen S, Oja S, Isosomppi R, Turjanmaa K . Efficacy and safety of hydrolyzed cow milk and amino acid-derived formulas in infants with cow milk allergy. J Pediatr. 1995; 127(4):550-7. DOI: 10.1016/s0022-3476(95)70111-7. View

Lifschitz C, Szajewska H . Cow's milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr. 2014; 174(2):141-50. PMC: 4298661. DOI: 10.1007/s00431-014-2422-3. View

Koletzko S, Niggemann B, Arato A, Dias J, Heuschkel R, Husby S . Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr. 2012; 55(2):221-9. DOI: 10.1097/MPG.0b013e31825c9482. View

10.

Fiocchi A, Restani P, Bernardini R, Lucarelli S, Lombardi G, Magazzu G . A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. Clin Exp Allergy. 2006; 36(3):311-6. DOI: 10.1111/j.1365-2222.2006.02428.x. View

11.

Fiocchi A, Travaini M, DAuria E, Banderali G, Bernardo L, Riva E . Tolerance to a rice hydrolysate formula in children allergic to cow's milk and soy. Clin Exp Allergy. 2003; 33(11):1576-80. DOI: 10.1046/j.1365-2222.2003.01781.x. View

12.

Reche M, Pascual C, Fiandor A, Polanco I, Rivero-Urgell M, Chifre R . The effect of a partially hydrolysed formula based on rice protein in the treatment of infants with cow's milk protein allergy. Pediatr Allergy Immunol. 2010; 21(4 Pt 1):577-85. PMC: 2904490. DOI: 10.1111/j.1399-3038.2010.00991.x. View

13.

Dupont C, Kalach N, Soulaines P, Bradatan E, Lachaux A, Payot F . Safety of a New Amino Acid Formula in Infants Allergic to Cow's Milk and Intolerant to Hydrolysates. J Pediatr Gastroenterol Nutr. 2015; 61(4):456-63. DOI: 10.1097/MPG.0000000000000803. View

14.

Sicherer S, Sampson H . Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014; 133(2):291-307. DOI: 10.1016/j.jaci.2013.11.020. View

15.

Hill D, Murch S, Rafferty K, Wallis P, Green C . The efficacy of amino acid-based formulas in relieving the symptoms of cow's milk allergy: a systematic review. Clin Exp Allergy. 2007; 37(6):808-22. DOI: 10.1111/j.1365-2222.2007.02724.x. View

16.

Dupont C, Kalach N, Soulaines P, Bradatan E, Lachaux A, Payot F . A thickened amino-acid formula in infants with cow's milk allergy failing to respond to protein hydrolysate formulas: a randomized double-blind trial. Paediatr Drugs. 2014; 16(6):513-22. DOI: 10.1007/s40272-014-0097-x. View

17.

Nowak-Wegrzyn A, Czerkies L, Collins B, Saavedra J . Evaluation of hypoallergenicity of a new, amino acid-based formula. Clin Pediatr (Phila). 2014; 54(3):264-72. DOI: 10.1177/0009922814557785. View

18.

De Boissieu D, Dupont C . Time course of allergy to extensively hydrolyzed cow's milk proteins in infants. J Pediatr. 2000; 136(1):119-20. DOI: 10.1016/s0022-3476(00)90063-5. View

19.

Arvola T, Moilanen E, Vuento R, Isolauri E . Weaning to hypoallergenic formula improves gut barrier function in breast-fed infants with atopic eczema. J Pediatr Gastroenterol Nutr. 2003; 38(1):92-6. DOI: 10.1097/00005176-200401000-00020. View

20.

Burks W, Jones S, Berseth C, Harris C, Sampson H, Scalabrin D . Hypoallergenicity and effects on growth and tolerance of a new amino acid-based formula with docosahexaenoic acid and arachidonic acid. J Pediatr. 2008; 153(2):266-71. DOI: 10.1016/j.jpeds.2008.02.043. View